TY - JOUR
T1 - Imminent fall risk after fracture
AU - Schene, Merle R.
AU - Wyers, Caroline E.
AU - Driessen, Annemariek M. H.
AU - Souverein, Patrick C.
AU - Gemmeke, Marle
AU - van den Bergh, Joop P.
AU - Willems, Hanna C.
N1 - Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Rationale: Adults with a recent fracture have a high imminent risk of a subsequent fracture. We hypothesise that, like subsequent fracture risk, fall risk is also highest immediately after a fracture. This study aims to assess if fall risk is time-dependent in subjects with a recent fracture compared to subjects without a fracture. Methods: This retrospective matched cohort study used data from the UK Clinical Practice Research Datalink GOLD. All subjects ≥50 years with a fracture between 1993 and 2015 were identified and matched one-to-one to fracture-free controls based on year of birth, sex and practice. The cumulative incidence and relative risk (RR) of a first fall was calculated at various time intervals, with mortality as competing risk. Subsequently, analyses were stratified according to age, sex and type of index fracture. Results: A total of 624,460 subjects were included; 312,230 subjects with an index fracture, matched to 312,230 fracture-free controls (71% females, mean age 70 ± 12, mean follow-up 6.5 ± 5 years). The RR of falls was highest in the first year after fracture compared to fracture-free controls; males had a 3-fold and females a 2-fold higher risk. This imminent fall risk was present in all age and fracture types and declined over time. A concurrent imminent fracture and mortality risk were confirmed. Conclusion/Discussion: This study demonstrates an imminent fall risk in the first years after a fracture in all age and fracture types. This underlines the need for early fall risk assessment and prevention strategies in 50+ adults with a recent fracture.
AB - Rationale: Adults with a recent fracture have a high imminent risk of a subsequent fracture. We hypothesise that, like subsequent fracture risk, fall risk is also highest immediately after a fracture. This study aims to assess if fall risk is time-dependent in subjects with a recent fracture compared to subjects without a fracture. Methods: This retrospective matched cohort study used data from the UK Clinical Practice Research Datalink GOLD. All subjects ≥50 years with a fracture between 1993 and 2015 were identified and matched one-to-one to fracture-free controls based on year of birth, sex and practice. The cumulative incidence and relative risk (RR) of a first fall was calculated at various time intervals, with mortality as competing risk. Subsequently, analyses were stratified according to age, sex and type of index fracture. Results: A total of 624,460 subjects were included; 312,230 subjects with an index fracture, matched to 312,230 fracture-free controls (71% females, mean age 70 ± 12, mean follow-up 6.5 ± 5 years). The RR of falls was highest in the first year after fracture compared to fracture-free controls; males had a 3-fold and females a 2-fold higher risk. This imminent fall risk was present in all age and fracture types and declined over time. A concurrent imminent fracture and mortality risk were confirmed. Conclusion/Discussion: This study demonstrates an imminent fall risk in the first years after a fracture in all age and fracture types. This underlines the need for early fall risk assessment and prevention strategies in 50+ adults with a recent fracture.
KW - accidental falls
KW - clinical practice research datalink
KW - imminent fall risk
KW - imminent fracture risk
KW - older people
KW - risk
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85176365829&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37930741
UR - http://www.scopus.com/inward/record.url?scp=85176365829&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ageing/afad201
DO - https://doi.org/10.1093/ageing/afad201
M3 - Article
C2 - 37930741
SN - 0002-0729
VL - 52
JO - Age and ageing
JF - Age and ageing
IS - 10
M1 - afad201
ER -